547 - A Retrospective Cohort Study of Treatment Patterns and Clinical Outcomes in Patients with COVID-19

The ePoster content is available to users who are logged in.<br><br>Please log in and then come back here to use this button.

Presenting Author(s)

Haley Pritchard

Assistant Professor of Clinical Medicine
Indiana University School of Medicine
Indianapolis, IN
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

JH

Jon Hiles

Clinical Pharmacist - Infectious Diseases
IU Health
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
BT

Batteiger Teresa

Assistant Professor of Medicine
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AD

Armisha Desai

Stewardship PHarmacist
Indiana University Health Adult Academic Health Center
Indianapolis, IN
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JW

Justin E. Wrin

Clinical Pharmacist - Infectious Diseases
IU Health
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AH

Ariel Hlavaty

Clinical Pharmacy Resident
IU Health
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AA

Amanda Agard

Post-Doctoral Fellow
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
BH

Bradley Hinton

Clinical Pharmacy Resident
IU Health
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
CL

Christine W. Lucky

Resident Physician
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
EF

Elizabeth Fleming

Resident Physician
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
HK

Humaira Khan

Medical Student
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JB

John P. Bomkamp

Clinical Pharmacist - Infectious Diseases
IU Health
West Lafayette, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Jon Derringer

Clinical Pharmacy Resident
IU Health
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JS

Jack G. Schneider

Faculty
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JR

Jonathan Ryder

Resident Physician
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JR

Jason D. Russ

Assistant Professor of Clinical Medicine
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
HK

Haseeba Khan

Resident Physician
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
SK

Svetlana Kleyman

Resident Physician
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
LE

Leslie A. Enane

Assistant Professor of Pediatrics
Indiana University School of Medicine
Indianapolis, IN, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
MS

Matthew Stack

Resident Physician
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
MK

Michelle L. Kussin

Clinical Pharmacist - Infectious Diseases
IU Health
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
CM

Courtney Myers

Post-Doctoral Fellow
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AN

Allysa Nagy

Resident Physician
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
NR

Noah Richardson

Resident Physician
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
OE

Omar Elsheikh

Post-Doctoral Fellow
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
OR

Omar Rahman

Assistant Professor of Clinical Medicine
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
RK

Rachel Kruer

Clinical Pharmacy Specialist
IU Health
Carmel, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
RT

Russell Trigonis

Post-Doctoral Fellow
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
SB

Saira Butt

Assistant Professor of Clinical Medicine
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
SB

Samina Bhumbra

Post-Doctoral Fellow
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
SK

Sasha Kapil

Resident Physician
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
TA

Tanya Abi-Mansour

Clinical Pharmacist
IU Health
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Zachary Howe

PGY2 Infectious Diseases Resident
Indiana University Health AHC
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Wassim Abdallah

Chief Resident
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Samir K. Gupta

Professor of Medicine
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: Gilead Sciences (Consultant, Scientific Research Study Investigator, Advisor or Review Panel member)ViiV (Consultant, Grant/Research Support, Scientific Research Study Investigator, Advisor or Review Panel member, Research Grant or Support)
KW

Kara Wools-Kaloustian

Professor of Medicine
Indiana University School of Medicine
Indianapolis, Indiana
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Background: The SARS-CoV-2 pandemic has caused over 400,000 deaths worldwide thus far, and poses therapeutic challenges for millions of patients. There is currently no treatment for SARS-CoV-2 infection approved by the United States Food and Drug Administration. Multiple agents have been used off-label to treat SARS-CoV-2 infection based on small observational cohorts and in vitro data. Here we present the experience of a large academic medical center in treating SARS-CoV-2 infection.

Methods: We performed a retrospective cohort study of patients admitted for greater than 24 hours with a nasopharyngeal, oropharyngeal, and/or bronchoalveolar lavage sample positive for SARS-CoV-2 by polymerase chain reaction (PCR). Demographic data, comorbidities, clinical data, and treatment data were collected from the electronic medical record. Off-label therapies were used at the discretion of the treating providers guided by regularly updated treatment guidelines assembled by infectious diseases physicians and antimicrobial stewardship pharmacists. The primary outcome assessed was in-hospital mortality. Secondary outcomes included admission to the intensive care unit (ICU), endotracheal intubation, initiation of vasopressors, and drug-related adverse events.

Results: Data collection was completed for 448 patients admitted between March 18, 2020 and May 8, 2020. All-cause in-hospital mortality was 13.4% (60/448) during this time. Mortality rates increased with age, up to 45% for patients over 80 years old. Male sex, hypertension, chronic pulmonary disease, end-stage renal disease, chronic liver disease were also risk factors for increased mortality. QTc interval prolongation occurred significantly more frequently in patients who received hydroxychloroquine (HCQ) with or without azithromycin(AZM) than those who did not (HCQ 6%, HCQ+AZM 7.8% vs all other patients, 0%, p< .0001). Review of treatment trends showed close adherence to the treatment recommendations at that time (Figure 1).Patient Characteristics

Admission Laboratory Data by Disease Severity

QTc Prolongation

Conclusion: SARS-CoV-2 infection is associated with significant inpatient mortality, and use of off-label treatments was associated with significant drug-related adverse events. Treatment regimens changed rapidly, and providers adhered closely to institutional guidelines as they evolved. Treatment Trends by Week

QTC pre/post Treatment by Hydroxychloroquine Use vs. No Hydroxychloroquine Use